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Xiphoid Process

What is Xiphoid Process?

Xiphoid process is a small projection of the lower part of the breastbone or known as the sternum and is made up of cartilage.

Xiphoid process is also known as metasternum, xiphisternum and xiphoid cartilage. It is located exactly at the center of the chest below the nipple line in a downward projection at the lowest portion of the rib that connects the sternum.

The xiphoid process has a sharp tip making it look like a sword. The primary function of which is in the attachment of a muscle that is significant for the breathing process which is called the diaphragm. Xiphoid process also serves as an attachment for rectus abdominus muscle and the transversus thoracis muscle.

Xiphoid process is generally an unsupported structure and unprotected by the ribcage that it is potential for an easy break off. The break in the xiphoid process is particularly potential during the cardiopulmonary resuscitation that extra care is necessary when performing CPR. The xiphoid process on the other hand is a safe landmark in determining the location of the apex of the heart when performing the cardiopulmonary resuscitation.

Xiphoid Process Structure

xiphoid processThe xiphoid process is the apparent protrusion in infant as it is basically a lump situated below the sternum notch during the early stage of life or during infancy. It is a soft and flexible cartilage during infancy and later fused to the sternum when it ossifies as the child is growing or developing. By the time an individual reaches the age of 15 to 29 years, the xiphoid process hardens and becomes bony.

The sternum is a flat and an elongated bone located in front of the chest. The xiphoid process is among the three parts that make up the sternum connected together by a cartilaginous joint known as synchondroses. The xiphoid process is triangular in shape with a sharp tip that resembles a sword.

Xiphoid process is deemed to be located at the 9th thoracic vertebra and at the T6 dermatome. The morphological variations of the xiphoid process tends to be inherited where in some people it can be bifurcated or split into two while it can be perforated to others. The variances in morphology of the xiphoid process on the other hand are not detrimental to the overall health status of an individual.

Xiphoid Process Pain

Xiphoid process generally does not cause any discomfort especially during the early stage of life when the process is just a protrusion of a soft lump. Xiphoid process however can have pain that can cause undue pain. Pain of the xiphoid process can be caused by several factors and early treatment is necessary to prevent serious problems and further discomfort.


The Xiphoid process syndrome is a pain or discomfort in the xiphoid process. The pain and discomfort is usually felt at the lower region of the sternum. Xiphoid pain is not a common condition and the symptoms are usually intermittent that the syndrome is usually not distinguished right away and only after a scrupulous medical examination can xiphoid process pain can be confirmed.

The symptoms of xiphoid process pain are often intermittent that it is rather difficult to determine the condition at first and is sometimes mistaken for other medical conditions. The pain in the xiphoid process can make an affected individual experience the following common symptoms:

  • Pain, tenderness and discomfort in the chest and chest area
  • The shoulders can also have pain, tenderness and discomfort
  • The back can also have pain, tenderness and discomfort
  • Pain, tenderness and discomfort can also be felt in the epigastric area
  • Nausea and vomiting may also be experienced
  • Abdominal pain


Xiphoid process pain can be due to several factors although at times the pain is difficult to pinpoint directly to the xiphoid process. The xiphoid process is generally an unsupported bone and unprotected by the rib cage. This location of the xiphoid process makes it highly potential for damages or break. In general, however, xiphoid pain is often caused by undisruptive activities such as lifting of weights and other heavy objects and can also be triggered by bending.

The causes of xiphoid pain can be caused by the following:

  • Lifting of heavy weights and objects
  • Repetitive and strenuous bending
  • Eating of large meal
  • Medications
  • Certain medical conditions or diseases

Cardiopulmonary resuscitation is an emergency procedure that is generally carried out to revive an individual who has suddenly stopped from breathing. Cardiopulmonary resuscitation basically aims to save lives. The xiphoid process however is generally at risk for break or fracture during the process of cardiopulmonary resuscitation where compression technique is applied to facilitate restoration of breathing. The break or fracture of the xiphoid process due to its unprotected and unsupported location is highly potential. A hard blow in the chest can also cause fracture of the xiphoid process which in turn can cause pain.


Xiphoid process pain is often a harmless condition that usually does not cause fatality. The danger of fracture in the xiphoid process however is the involvement of the other internal organs which can get punctured by the fragments of the bone of the xiphoid process. Treatment is generally necessary and pain in the xiphoid process should not be ignored.

The treatment for xiphoid process pain depends on the cause of the pain. It is especially important to consult a doctor to identify the cause of pain that is tantamount to the proper treatment method.

Lump on the Sternum

The sternum is essential for the attachment of the ribs and which runs vertically along the midline of the upper portion of the body. The structure of the sternum basically starts at the sternal notch or the base of the throat while it ends at the bony and cartilaginous protrusion known as the xiphoid process.

The lump on the sternum is often not due to any serious medical condition such as growth of tumor. For most of palpable lumps on the sternum, it is basically due to the xiphoid process. It does not mean however that palpable lump on sternum should be ignored. It is still necessary to consult a doctor especially when one suspects otherwise.

Xiphoid Process
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